Welcome to Professional and Technical Services (PTS) – experts in chemical disinfection for infection prevention. Our goal is to educate and provide you the latest resources related to cleaning and disinfection of environmental surfaces, medical devices and hands. As specialists in disinfectant chemistries, microbiology, environmental cleaning and disinfection, facility assessments and policy and procedure creation we are dedicated to helping any person or facility who uses chemical disinfectants.

Friday, November 30, 2012

In May, the Chemistry Blog focused on Hydrogen Peroxide.Now, you might wonder, why
then would we dedicate a second blog to Hydrogen Peroxide.Aside from the fact that the Improved H2O2
formulations are patented, the primary reasoning is that these formulations
truly stand out as unique and novel technologies that warrant further
discussion.

Ever since the progression of the medical sciences
various chemicals have been used as active ingredients for disinfection and
sanitization, with the newer actives being more effective, safer, and easier to
use. Currently, the most common disinfectants use quaternary ammonium compounds
(QUATS), alcohols, or sodium hypochlorite (bleach) as their active ingredients.
The use of above actives imposes various problems such as user hazards,
efficacy limitations, and negative environmental effects. Improved Hydrogen Peroxide has successfully tackled all these issues.

Improved Hydrogen Peroxide formulations contain varying
levels of Hydrogen Peroxide in combination with anionic and /or non-ionic surfactants (detergents), and other inerts such as chelating agentsand wetting agents.This combination of chemicals
works in synergy to provide exceptional cleaning efficiency but most importantly,
from an infection prevention perspective, boosts the antimicrobial speed and
spectrum of efficacy of hydrogen peroxide.Improved Hydrogen Peroxide leaves no residues on applied surfaces as it
turns into water and oxygen upon drying, and imposes no use or environmental
hazards as its use concentrations and decomposition products are very low and
thus safe.In fact, Improved Hydrogen
Peroxide formulations have attained the lowest toxicity category as defined by
the US EPA.As Category IV classified
compounds they are considered practically non-toxic and non-irritating.

Improved Hydrogen Peroxide products are commercially
available through a number of companies in various concentrations ranging from
0.5% to 7% and varying applications.Such companies have differing marketing terminology for their patented
technologies such as “Accelerated Hydrogen Peroxide” or “Activated Hydrogen Peroxide”.As per the advantages
described above, Improved Hydrogen Peroxide is a well-rounded active ingredient
that has no limitations in its use at ranges of product types. At concentrations
of 0.5% to 1.4%, Improved Hydrogen Peroxide formulations can be used for
cleaning and disinfection of environmental surfaces and non-critical
devices.Improved Hydrogen Peroxide
formulations with peroxide concentrations higher than 2% can be used as high
level disinfectants and chemosterilants; solutions that can be used to submerge
semi-critical and critical medical devices. Utilization of Improved Hydrogen
Peroxide in hand sanitizers is another new method for skin surface sanitizers.
Its use provides superior antimicrobial efficacy without endangering the users
by skin sensitization, toxic chemical residue leftover, or risks of oral
consumption abuse. Similar to the dermal applications, the use of Improved
Hydrogen Peroxide for animal hygiene is also another advantage to produce
animal care products that are both safe and effective. Due to generally high
compatibility and low corrosiveness of Improved Hydrogen Peroxide, its
disinfectant solutions are also used to disinfect a variety of sensitive
medical instruments and apparatuses. Improved Hydrogen Peroxide is not limited
in its uses; more areas of development are considering its use while its
acceptance among the end users is growing due to its advantages.

Depending on application Improved Hydrogen Peroxide
formulations are utilized within a spectrum of various concentrations.Taking this into account, here’s how we would
score Improved Hydrogen Peroxide on the key decision making criteria:

o Depending on the Improved Hydrogen Peroxide formulation
they are capable of killing all microorganisms; bacteria, viruses, fungi,
mycobacteria and spores.

• Cleaning Effectiveness – A

o Excellent cleaning capabilities as the formulations
include a blend of non-ionic and anionic surfactants which are known to provide
superior cleaning in conjunction with H2O2 which also aids in cleaning

• Safety Profile – A to B

o At their in-use concentrations, surface disinfectants
are non-toxic and non-irritating for users.

o Instrument disinfectants are non-toxic and do not
require special ventilation systems

• Environmental Profile – A

o H2O2 degrades into water and oxygen.

o Some Improved Hydrogen Peroxide surface formulations
have been developed to achieve Eco-certifications such as EcoLogo and EPA’s
Design for the Environment (DfE).

Thursday, November 22, 2012

Everybody’s hands are frequently contaminated with
enteric microorganisms, and food workers are no exception. These workers may be
even more exposed because of their work with raw food ingredients and their
frequent contact with fellow workers and the public.

Unlike hand contamination with staphylococci from the
nasopharynx, the enteric bacteria that contaminate the hands of food workers
more often are associated with raw foods of animal origin rather than poor
personal hygiene after visiting the toilet.

Hand hygiene compliance at the retail food service level
is known to be inadequate. Hand hygiene practices of food workers are dependent
on the type of work involved and the type and nature of the soil on their
hands. Compliance begins with a commitment by management to designate safety as
the number 1 concern in the establishment and to introduce regular training
programs for safe production of food, as well as when and how to wash hands
effectively.

Many people, workers included, feel that their hygiene
routines are sufficient because no adverse consequences have been experienced
over many years of performing the same procedures. Gross hygiene errors may be
in place for a long time in foodservice operations and not be identified until
associated illnesses are reported. For instance, two United Kingdom catering
facilities (in Scotland and Wales) were thoroughly investigated in public
inquiries following large outbreaks with illnesses and deaths. Workers with
management acceptance had contaminated cooked meat products.

Washing

Hand washing times of 15 to 30 seconds have been
recommended by different agencies around the world. For many years sanitarians
have specified that the hands of food service workers should be washed and
rinsed in hot water to reduce the risk of cross-contamination and disease
transmission. However, the use of water at these temperatures has not been
supported by research. Hand washing with water at high temperatures may
contribute to skin damage when frequent hand washing is required, and
insistence on hot water usage may be a deterrent to hand washing compliance.

To reduce the potential for bacterial transfer, food
workers may need to wash their hands for longer than 15 seconds or may need to
wash more often. Thorough rinsing is important because this action also removes
potential skin irritants and contact sensitizers originating in food, soaps,
metals, and facility disinfectants that could lead to dermatitis. Triclosan,
triclocarban-trichlorocarbamide, and parachlorometaxylenol-chloroxylenol are
commonly used antibacterial hand cleaning agents, however Gillespy and Thorpe
found that germicidal soaps were not remarkably more effective than ordinary
soap for reducing the numbers of bacteria transferable from the skin to handled
objects. Infectious disease outbreaks have also been linked to workers with
long or artificial fingernails. Without the regular use of a nail brush, they
are very difficult to clean even with appropriate soaps, hand rubs, or gels.

Drying

Hand drying has two effects: removal of moisture through
absorption and removal of microorganisms through friction. The friction
generated during hand drying is even more important than that generated during
washing because the soaping stage has loosened the microorganisms from the
skin. The drying stage physically removes microorganisms in a film of water
from the skin by wiping and depositing them on a towel. Thus, hand hygiene
efficiency is a combination of washing efficiency (soap, water, rubbing, and rinsing)
and hand drying.

Although cloth towels are popular because of their rapid
drying, they become contaminated through multiple usages, and once pathogens
are deposited on towels, they can survive long enough to contaminate the hands
of other users. Cellulose fiber is the main material in institutional paper
towels, which are usually made of rougher paper than used for domestic paper
towels. The coarser the grain of paper used, the more efficient the friction
effect will be for organism removal, although harsh, non-absorbent paper towels
could discourage their use compared to softer paper. Also, hand-operated paper
towel dispensers have their limitations.

In a survey of 12 food processing or food service
facilities, researchers found coliforms, E. coli, and S. aureus on paper towel
dispenser equipment. Air driers that are used in many communal washrooms allow
one user at a time, and that take up to 1 minute to dry the hands, have not
been convenient and lead to avoidance or incomplete drying. In several studies,
on average people spent 22.5 seconds drying hands, and 41% wiped their hands
unhygienically on clothes. Newer fast air flow driers are becoming more
widespread, but have yet to be completely evaluated for their sanitary
qualities.

Because of the uncertain or limited effectiveness of hand
hygiene, multiple hurdles to reduce pathogen contamination and reduce their
spread are better than one or two hurdles. When coupled with glove use and
proper handwashing, these steps should minimize the opportunities for pathogens
to reach the food being prepared.

Prof. Todd is an Adjunct Professor with the Food Science
and Human Nutrition Department at Michigan State University.As a scientist with over 45 years in food
safety, in particular relating to foodborne outbreaks, Prof. Todd has written
many publications and spoken at national and international meetings. He is
currently working on Listeria transfer coefficient and modeling projects,
hygiene in child care centers, avoidance of norovirus in elder care facilities,
and rapid recall and traceability research in multidisciplinary projects with
colleagues at MSU and other universities.

Friday, November 16, 2012

As winter approaches, more and more people start to feel
like they’re coming down with “something.” You can always tell when cold and
flu season has arrived at our offices because when our team gets together for a
meeting, it’s like watching children playing a game of musical chairs.Everyone is vying to find a seat farthest
away from the “sick” person and best of all it’s the “older” colleagues that
seem to freak out the most....I suppose that could be due to their declining
immune systems.Today there were three
of us “sickies” and without intending we did a darn good job of spreading out
and making it virtually impossible for our colleagues to find a spot where they
weren’t in some way going to come in contact with us.

In some latest polling information it has been reported
that nearly 80 percent of office workers come to work even when they know they
are sick.For those that stay home, more
than two-thirds return to work when they are still contagious, putting
coworkers' health and business productivity at risk.In a typical year, approximately 70 million
missed workdays can be attributed to having the flu which can be translated to
an estimated $10 billion in lost office productivity.

So how do you know if you have the flu or the common cold?Both have similar symptoms, so it can be hard
to tell the difference.In general, the
flu is worse than the common cold. Symptoms such as fever, body aches,
tiredness, and cough are more common and intense with the flu. People with colds are more likely to have a
runny or stuffy nose.

Unless you have young children where you basically just
have to come to terms that if they’re sick, you’re going to be sick, the tricks
to avoid catching the flu or cold are pretty simple.

1. Wash your hands!Wash after you shake hands, after you go to the “facilities” and by gosh
WASH BEFORE YOU EAT!

2. Clean and disinfect your workspace! (when was the last
time YOU actually wiped down your desk, phone, keyboard or mouse with a
disinfectant wipe?)

3. Stay Away!Coughs and sneezes spread diseases!Keep your distance from people displaying symptoms – respiratory
droplets from coughs and sneezes can spread for up to 6 feet!

4. Get your Flu Shot! (and no, the flu shot will not give
you the flu...)

Let’s do a case study:

One of my colleagues and I were at a conference this week
from Sunday to Tuesday. As luck would
have it, this also happens to correspond to the first 3 days my cold came
on. With the cold viruses, the first 3
days tend to be when you are most infectious and colds generally have an
incubation period of 2 – 5 days.To my
defense, I covered my mouth when I sneezed or coughed, sat at the end of the
rows to try and keep my distance from others and washed my hands or used hand
sanitizer CONSTANTLY! Melissa who I was
travelling with has started showing signs of a cold (she sat beside me on the
plane, at the conference – definitely not 6 feet away from my respiratory
droplets regardless of how well I tried to contain them). She’s coming to work. She’s definitely infectious.

Assuming by Monday, several more team members are showing
symptoms of a cold, am I to blame?I
didn’t come to work while sick – I was away!It’s Melissa’s fault right?

Bugging Off!

Nicole

PS – sorry to anyone who attended #SocialintelATL if
you’re coming down with a cold.....

Friday, November 9, 2012

While writing does not always come easy, one of the
things I like most about writing the Talk Clean To Me Blog is that I can state
my opinion in black and white with the hopes that some may agree and welcome
the dialogue that occurs with those of you who think I’m completely off my
rocker.

In the world of cleaning and disinfection, the science or
proof some people rely on cannot keep up with the myriad of new products or
processes that enter the market place.Does this mean that one should not consider changing products or
processes until such time as there is statistically significant information
published about these new products or processes?Most definitely not!

Let’s consider the pre-moistened disinfectant wipe.Are they new to the market?NO.Have
they been used successfully at many facilities across the globe?YES.To ensure a successful infection prevention program, do we need to
consider how to use them correctly to ensure the desired outcome?MOST DEFINITELY!

“Disinfectant wipes should be used by the primary care
giver for point of care cleaning and disinfecting of patient equipment. They
should not be used as a routine cleaning disinfectant tool.”

Admittedly, for the sake of keeping the blog to a
reasonable length, I have not included the entire section, however, should you
take the time to read the guideline, you will find that it is vague and without
any references to support its justification.While I agree wholeheartedly that all disinfectants must be used
appropriately, the danger in making such a statement is that there is no strong
scientific evidence to conclusively limit the use of pre-moistened wipes at
this time.Perhaps instead, there
should have been a more detailed discussion about the appropriate use of
pre-moistened disinfecting wipes to ensure that they are used in such a fashion
as to ensure contact time in accordance to the label is met.Many of the leading pre-moistened wipes
available on the market are Quat-alcohol based products with anywhere from 2 to
5 minute contact times.As proven by
science, such products will not remain on the surface for the contact time
listed on the label as a result of the rapid evaporation rate of alcohol.In fact a study published by Omidbakhsh in 2010 in the Journal of AOAC International investigated the discrepancy between
drying time and contact time with respect to product efficacy.Additionally, there have been publications
investigating the effects of wipes in contaminating surfaces providing
compelling evidence that we want to use 1 wipe for each surface especially if
using a weak or slow-acting disinfectant in the wipe where the true chances of
achieving disinfection are limited at best.

That said, proper disinfection with such wipes can be
achieved with the physical action of wiping provided the disinfectant itself
has a good and rapid broad-spectrum microbicidal activity. Therefore, there has
to be a change in our thinking with regards to contact time for wipes as
opposed to longer contact times needed when just spraying or pouring a liquid
on surfaces. Perhaps the conclusion should be that in choosing a pre-moistened
disinfectant wipe, one must consider more than just the cost per wipe. There
needs to be a more fulsome investigation as to the number of wipes needed to
achieve the contact time as listed on the label.We need to review how the wipes will be
utilized to ensure that good physical friction will be applied to help in
removal of the pathogens from the surface, as well as frequent changing of such
wipes to avoid redistributing the removed pathogens.Lastly, one cannot discount the size of the
wipe.Certainly, the traditional wipes
used in clinical areas for disinfecting patient care items such as BP Cuffs or
Stethoscopes would not be recommended for use by Environmental Services due to
their smaller size, however, most companies specializing in pre-moistened wipes
provide larger options (10x10 inches or 12x12 inches) which are more than
adequate for cleaning larger surfaces sizes.

Perhaps the use of pre-moistened disinfectant wipes is no
different than the use of antibiotics?When prescribing antibiotics you need the right drug at the right
concentration for the right length of time.For pre-moistened wipes you need the right claims, the right contact
time and the right size to do the job.

Friday, November 2, 2012

Peracetic acid (PAA) was first registered as a
disinfectant in 1985 by the EPA. PAA is produced by combining acetic acid
(vinegar) and hydrogen peroxide.The
result is a peroxide version of acetic acid (vinegar) that has a very
distinctive and a pungent vinegary smell.It is a weak acid compared to acetic acid but can be highly corrosive if
not used at the appropriate dilutions. Peracetic acid is a versatile chemical
that can be used in a variety of applications with its main use as a
disinfectant product in food and beverage processing/producing plants due to
the fact that it leaves no harmful residues and decomposes into harmless by-products.

As a cleaner, peracetic performs poorly as it lacks
detergency properties.As alluded to in
previous blogs, you may wonder whether increasing the concentration of this
acid would benefit its cleaning. The answer in short is: No. A higher
concentration would not increase its cleaning abilities and in fact would lead
to an increase in corrosiveness.

As a germicide, peracetic acid shows fairly strong
efficacy against a broad spectrum of pathogens. Like many disinfectants, the
temperature, pH and concentration all play a significant role in determining
the antimicrobial properties. It is bactericidal at 10ppm, fungicidal at 30 ppm
and virucidal at 400 ppm in a 5 minute contact time. Furthermore, it is
sporicidal at concentrations of 3000 ppm. It is more effective at slightly
higher temperatures and its germicidal activity increases at higher pH ranges.
Combinations of PAA and hydrogen peroxide further boost the efficacy profile,
as this blend can prevent the formation of biofilms on hard surfaces. The
method by which PAA attacks pathogens is through the reaction with the cellular
walls. This leads to breakdown of cell membranes and cellular death due to cell
content leakage. An issue regarding PAA usage is its stability. In the presence
of water, it breaks down quickly. This would have a direct affect on the
viability of the product over time.

Peracetic acid’s safety profile can also be closely
correlated to its concentration. The higher the concentration, the worse the
safety profile is. For example, an in use solution of PAA of 5% has relatively
low oral toxicity at this dilution. However, respiratory issues, including
occupational asthma development associated with PAA have been reported.
Further, it can strongly sensitize respiratory organs and cause mucus membrane
inflammation. Furthermore it is important to be weary of skin and eye exposure
as it can cause irritation. Overall, peracetic acid proper care needs to be
taken in its use.

The environmental profile of peracetic acid once again
depends on the concentrations encountered. At high concentrations, it can be
toxic. However, in use concentrations do not pose major threats to the
environment. Furthermore, PAA is a readily decomposable substance and breaks
down to products that are not considered harmful to the environment.

This is how we would rate peracetic acid disinfectants
based on the key decision making criteria:

• Speed of Disinfection – B to C

o At a 5 minute contact time for killing bacteria and
viruses, peracetic acid is fairly rapid in killing. However it carries a 30
minute sporicidal contact time, which is unrealistic unless used for soaking
applications.